Organization
JACKALOPE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BLUME LCSW (OWNER)
(405) 237-5696
Entity
Organization
Contact information
Practice address
1119 LEAFHURST RD, MOORE, OK 73160-8533
(405) 237-5696
Mailing address
1119 LEAFHURST RD, MOORE, OK 73160-8533
(405) 237-5696
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/01/2025
Last updated
10/16/2025
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